By CRAIG FREILICH

POTSDAM – Some day soon, most patients around the country will be able to get on the Web and check their medical records, but patients at Canton-Potsdam Hospital clinics can do it now.

CPH is among the first hospitals in the region to get certification in the first stage of implementing a comprehensive electronic medical records system, which will include “patient portals,” a way for patients to do things like access their records and make appointments.

“A patient portal is a website the patient can use to go to a hospital or clinical environment to get things like a copy of health records, summary notes, medical billing, and to do things like scheduling and prescription refill requests,” said CPH Chief Information Officer Jorge Grillo.

Right now, the CPH patient portal is only available at clinic practices, but people are already using it. Grillo says that in a recent 90-day period, more than 120 patients had accessed the portal.

Grillo explained that patient portals are seen as a way to allow people access to their health providers, including examining health records, setting up lab and other appointments online, paying bills, and generally making interactions more effective and efficient.

Transition to Electronic Records

It is part of the move among health care providers everywhere toward electronic health records (EHR), the storage and retrieval of records electronically, which has become a requirement of federal law. It is all aimed at improving efficiency and reducing costs while giving patients more control over their health care records and decisions, with the overall goal of improved care.

But that transition is neither easy nor is it quick, according to Grillo.

As CPH said in a recent statement, electronic medical records “will provide a seamless link between offices of physicians and allied health professionals in Canton-Potsdam Hospital's outpatient primary care centers and outpatient specialist clinics. If a patient is seen in one of these outpatient areas, the information will be available to the hospital instantly. The hospital is hopeful to be able to offer a similar service to private practices in the future.”

“It’s not necessarily what hospitals have today,” Grillo said. “The concept is nothing new, but the requirement to have one is new.”

As hospitals move to electronic health records, they are urged on by federal legislation such as the Obamacare HITECH Act and the American Recovery and Reinvestment Act of 2009 -- the “stimulus package.” That legislation has set goals and offers incentives for providers as they adopt new methods of recordkeeping.

The requirements are forcing hospitals across the country to move carefully as they shop for software and design their systems.

‘Carrot and Stick’

“The government is taking a carrot and stick approach,” Grillo said. “For the implementation of stage one, the government gave some money for reimbursement, and grants to pay for the technical requirements.”

Grillo said CPH had received their first reimbursement under the program for achieving the “meaningful use” requirements of the first stage.

“A lot of us were waiting on release of ‘meaningful use’ Stage Two standards. Those have been finalized now, so that we can start technical and process solutions that meet the requirements.”

Those “meaningful use” requirements are just what they sound like: Is this stuff working and is it making a difference, with things such as successfully putting EHR to use in areas like "e-prescribing" and the electronic exchange of health information to improve quality of health care?

Grillo said the software vendors have some work to do to help hospitals stay on target.

“We’re waiting to see what the vendor community is doing because they are not certified yet.”

Tale of Two Systems

Another complication is that hospital software solutions have grown up around two segments of health work, outpatient and inpatient care, and that two kinds of software systems have evolved separately. Vendors are beginning to develop and offer software that will handle both, but right now that option is very expensive.

“That’s one reason CPH and other hospitals are challenged to decide if they will use one patient portal system or two, one inpatient, the other outpatient.”

Grillo talked about making a “wrapper” for the two systems to make it easier for the user to navigate.

“You can build your own wrapper or you can buy from different people and bolt it together,” but there is no simple, affordable solution yet.

But staff at CPH are all proceeding in the hope that, in the long run, the new requirements will make their work quicker and easier, and improve patient outcomes at the same time.

There is also the disincentive of a loss of reimbursements if they don’t meet targets and deadlines.

“If by 2015, a hospital has not reached stage one in the process, it could lose a percentage of Medicare reimbursements,” Grillo said, and explained that Canton-Potsdam is ahead of the curve.

“CPH has spent the last two years achieving the ‘meaningful use’ requirement of stage one. We’ve been certified since July.” Grillo said he believed CPH was one of the first to achieve Stage One certification in the North Country.

“We’re doing it because it’s the right thing for the patient, not because it’s a government mandate. Functionally we don’t have to do it. We can take the one percent Medicare hit. It would probably be cheaper in the short run. But this is the right thing for the patient,” Grillo said.

“Technology will be key to providing quality improvements and cost reduction. It’s where the industry is going. If you’re going to be a player and get on the train, you’re going to have to have the service equivalent of what everyone else is getting.”

Grillo also said that while Canton-Potsdam Hospital has every expectation of meeting the targets and getting a good system up and running, some smaller hospitals might be more challenged to complete the process.